Plasmacytoma

Plasmacytoma is a primary systemic malignancy of marrow origin; B-cell origin with plasma-cell differentiation. Solitary osseous plasmacytoma is rare and curable. Multiple plasmacytoma most common: osteolytic lesions + marrow plasma-cell infiltrate, plus anemia, hypergammaglobulinemia, hypercalcemia, renal impairment, and infection predisposition.

Common Symptoms

Bone-marrow plasmacytosis; radiating pain; amyloidosis; diffuse low back pain; fatigue; proteinuria; spinal-cord compression

Causes and Pathogenesis

Known risk factors: high-dose ionizing radiation, chronic antigen stimulation, viral infection; also late-stage chronic osteomyelitis/pyelonephritis/TB. Elderly predominance (immune senescence, thymic involution). Multi-step tumorigenesis: thymic involution → loss of early B-cell control/polyclonal hyperplasia → random mutation → malignant clone. Familial cases reported. Pathology: (1) Gross: gray-red soft marrow-replacing tumor; nodules coalesce; hemorrhage/cystic change/necrosis; expands cortex; spine → cord/nerve-root compression. (2) Microscopy: dense plasma-cell clusters, scant stroma; abundant basophilic cytoplasm, eccentric round nucleus, perinuclear hof (Golgi), clock-face chromatin, crystals; well-differentiated = typical plasma cells; poorly differentiated = large/pleomorphic cells, nucleoli, mitoses, multinucleated giant cells.

Treatment

Drug, supportive therapy

Preventive Measures

(1) Good habits; stop smoking/limit alcohol (WHO: 1/3 cancer reduction in 5y if no smoking); avoid acidic body constitution. (2) Avoid salty/spicy/overhot/overcold/expired food; eat cancer-preventive/alkaline foods if elderly/genetically predisposed; stay positive.

Department to Visit

It is recommended to visit the Medical Oncology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.